INVESTIGATION
CONSENT FORM: This investigation is designed to examine the impact of high personal
standards of relationship conduct on the nature of people's intimate, romantic
relationships. More specifically, in the present research you will be asked to respond to
the items on a questionnaire dealing with general views about intimate relationships.
Topics dealing with intimate relationships are a vital aspect of our lives, and as such we
think that they are an important focus for study. Thus we encourage you to participate in
this project. All of the information gathered in this project is completely confidential.
The resulting information will be used only for research purposes. No individual other
than the researcher (Dr. Snell) will ever have access to the responses which you provide
in this study. Also, all of the information gathered in this project is anonymous. No
names, including your own name, will be attached to the data itself. Any participant may
withdraw from this project at any time--and there will not be any penalty for doing
so. INFORMED CONSENT: I do hereby give
my informed consent to participate in this research project. I understand that
participation in the project is entirely voluntary. I also understand that an individual
may withdraw from the project at any time without being penalized in any way.

Please Type in Today's Date
(month-day-year):

Do you FREELY and WITHOUT PRESSURE consent to participate in this research (type
"YES"):

This survey will take about 20
minutes to complete. Thank you.

Page # 1

SURVEY INSTRUCTIONS: Listed below are several statements that concern people's views
about romance. Please read each item carefully and decide to what extent it is
characteristic of you. Some of the items refer to a specific romantic relationship.
Whenever possible, answer the questions with your current partner in mind. If you have
never been in a romantic relationship, answer in terms of what you think your responses
would most likely be. Then, for each statement select the response that applies to you by
using the following scale:

A = Not at all characteristic of me.
B = Slightly characteristic of me.
C = Somewhat characteristic of me.
D = Moderately characteristic of me.
E = Very characteristic of me.

NOTE: Remember to respond to all items, even if you
are not completely sure.
Your answers will
be kept in the strictest confidence.
Also, please be
honest in responding to these statements.

39. It is important to me that I am thoroughly competent
as a romantic partner.

40. I am rather neat (i.e., not messy) in my romantic
relationships.

Please respond to all
questions. Thank you.

41. I try to take an organized approach to my romantic
relationships.

42. If I fail to satisfy my romantic partner, I am a
failure as a romantic partner.

43. I should be upset if I make a mistake with my romantic
partner.

44. My partner wants me to be the best possible romantic
partner in the world.

45. I set higher goals for myself as a romantic partner
than do most people.

46. If someone were a better romantic partner than I, then
I myself would feel like a romantic failure.

47. If I fail in any way to be a totally good romantic
partner, it is as bad as being completely inadequate.

48. Only when I am an "outstanding" romantic
partner is it good enough for my romantic partner.

49. I am very good at focusing my efforts at satisfying my
romantic partner.

50. Even when I am very careful as a romantic partner, I
often feel that I failed to do something quite right.

Please respond to all
questions. Thank you.

51. I hate being less than the best possible romantic
partner.

52. I have extremely high (performance) goals for myself
as a romantic partner.

53. My romantic partner expects "relationship
excellence" from me.

54. My romantic partner would probably think less of me if
I made a mistake in our romantic relationship.

55. I never feel like I can meet my romantic partner's
expectations for me.

56. If I am not as good at romance and intimacy as other
people, it means I am an inferior person.

57. Other people seem to accept less from themselves as a
romantic partner than I do for myself.

58. If I do not constantly attend to our romantic
relationship, my partner will not respect me.

59. My partner has always had higher expectations for our
romantic relationship than I have.

60. I try to keep things neat and organized in my romantic
relationship.

Please respond to all
questions. Thank you.

61. I usually have doubts about even the simple things I
do and say with my romantic partner.

62 In my romantic relationships, orderliness (and
neatness) is very important to me.

63. I expect more of myself as a romantic partner than
most people.

64. I take an organized approach to my romantic
relationships.

65. I tend to have problems in my romantic relationships
because I keep doing things the same old way.

66. It takes me a long time to do things in the
"right" way in my romantic relationships.

67. The fewer mistakes I make as a romantic partner, the
more my partner will like me.

68. I never feel like I can meet my partner's romantic
expectations/standards for me.

Please respond to all
questions. Thank you.

Page # 2

INSTRUCTIONS: Please select the letter
for each item which best answers that item for you.

69. How well does your partner meet your needs?

70. In general, how satisfied are you with your
relationship?

71. How good is your relationship compared to most?

72. How often do you wish you hadn't gotten in this
relationship?

73. To what extent has your relationship met your original
expectations?

74. How much do you love your partner?

75. How many problems are there in your relationship?

Page # 3

76. Following are
descriptions of four general relationship styles that people often report. Please read each
description and indicate the one style that best describes you or is closest to
the way you generally are in your close relationships.

A = It is easy
for me to become emotionally close to others. I am comfortable depending on them and
having them depend on me. I dont worry about being alone or having others not accept
me.

B = I am
uncomfortable getting close to others. I want emotionally close relationships, but I find
it difficult to trust others completely, or to depend on them. I worry that I will be hurt
if I allow myself to become too close to others.

C = I want to be
completely emotionally intimate with others, but I often find that others are reluctant to
get as close as I would like. I am uncomfortable being without close relationships, but I
sometimes worry that others dont value me as much as I value them.

D = I am
comfortable without close emotional relationships. It is very important to me to feel
independent and self-sufficient, and I prefer not to depend on others or have others
depend on me.

Page # 4

INSTRUCTIONS: Please rate
each of the following relationship styles according to the extent to which you think each
description corresponds to your general relationship style. Use the following scale for
the next 4 questions.

A = Not at all characteristic of me.
B = Slightly characteristic of me
C = Somewhat characteristic of me.
D = Moderately characteristic of me.
E = Very characteristic of me.

77. It is easy for me
to become emotionally close to others. I am comfortable depending on them and having them
depend on me. I do not worry about being alone or having others not accept me.

78. I am uncomfortable
getting close to others. I want emotionally close relationships, but I find it difficult
to trust others completely, or to depend on them. I worry that I will be hurt if I allow
myself to become too close to others.

79. I want to be
completely emotionally intimate with others, but I often find that others are reluctant to
get as close as I would like. I am uncomfortable being without close relationships, but I
sometimes worry that others do not value me as much as I value them.

80. I am comfortable
without close emotional relationships. It is very important to me to feel independent and
self-sufficient, and I prefer not to depend on others or have others depend on me.

Page # 5

INSTRUCTIONS: The items listed below refer to people
in a close relational--i.e., a relationship between two partners in an intimate
relationship. Please read each item carefully and decide to what extent it is
characteristic of your feelings and behaviors. Give each item a rating of how much it
applies to you by using the following scale:

INSTRUCTIONS: The items listed below
refer to people in a close relational--i.e., a relationship between two partners in an
intimate relationship. Please read each item carefully and decide to what extent it is
characteristic of your feelings and behaviors. Give each item a rating of how much it
applies to you by using the following scale:

124. I am less than happy with my ability to sustain an
intimate relationship.

125. I'm constantly thinking about being in an intimate
relationship.

126. I would rate myself as a "poor" partner for
a close relationship.

127. I feel down about myself as an intimate partner.

128. I think about intimate relationships a great deal of
the time.

129. I am confident about myself as a relationship
partner.

130. I feel unhappy about my interpersonal relationships.

Please respond to all
questions. Thank you.

131. I seldom think about being involved in a close
relationship.

132. I am not very confident about my potential as an
intimate partner.

133. I feel pleased with my love relationships.

134. I hardly ever fantasize about highly intimate
relationships.

135. I sometimes doubt my ability to maintain a close
relationship.

136. I feel sad when I think about my intimate
experiences.

137. I probably think about love relationships less often
than most people.

138. I have few doubts about my capacity to relate to an
intimate partner.

139. I am not discouraged about myself as a loving
partner.

140. I don't think about intimate relationships very
often.

Please respond to all
questions. Thank you.

Page # 7INSTRUCTIONS: The following demographic data
will be used only to describe the group characteristics of the resulting sample of
participants (e.g., 25% were young and 75% were older). They will not be used to identify
individual responses.

1. What is your Marital Status?

2. How long have you been married
(total number of years)?

3. How many children do you have?

4. What is your own income?

5. What is your spouse's income?

6. What is your gender?

7. What is your ethnic heritage?

8. What is your religious heritage?

9. What is your age?

10. What is your spouse's age?

11. Are you in love now?

12. How large is the place where you live?

13. How frequently do you attend church?

14. What is your current living arrangement?

15. Are your parents divorced?

16. What is your level of education?

17. What is your spouse's education level?

18. How many children do you have?

19. How old are you (number of years)?

20. What is your Race / Ethnicity?

21. In what country do you live?

You are finished!
Thank you for taking the time to respond to this research survey.If you would like additional information about this
research, e-mail me at wesnell@semovm.semo.edu.
If you wish to see a brief description of this research, click here: Debriefing.